Background/Aim. Retroperitoneal fibrosis (RPF) represents a chronic
pathological process characterized by fibrosis which entraps and compresses
the ureters and the great blood vessels in the retroperitoneal space. A
specific form of RPF is idiopathic RPF, an uncommon collagen vascular
disease of unclear etiology. The series of 15 patients which underwent open
surgical repair due to idiopathic RPF is presented herein. Methods. From
1989 to 2012, 11 male and 4 female patients underwent surgery due to primary
RPF. The ureters were entrapped unilaterally (7 patients), or bilaterally (8
patients). Major symptoms included low back pain due to hydronephrosis (9
patients), uremia (4 patients), and urinary tract infection (2 patients).
The diagnosis was based on intravenous urography (IVU), retrograde
ureteropyelography and computed tomography (CT). Results. Surgical
procedures included intraperitoneal ureteral displacement (8 patients) and
ureteral wrapping with omental flap (6 patients). One patient underwent
bilateral ureteral stenotic segments resection and oblique ureterography,
followed by wrapping with omental flap. Pathological examination confirmed
primary RPF in all patients. The mean operative time was 3.5 h (range
2.5-4.5 h). The average intrahospital stay was 21 days (range 16-26 days).
The mean follow up was 32 months (6-46 months). During the follow up, 12
patients had improvement on IVU. Conclusion. Early recognition of signs and
symptoms of RPF is of the utmost importance for the outcome. Surgical
procedures, including ureteral wrapping with omental flap, or
intraperitoneal ureteral displacement, usually represent definitive
treatment.
Thoracolaparoscopic carinal resection and reconstruction using pedicle omental flap
